UTI in the Elderly: Complications, Symptoms and Quick Treatment Guide

UTI or urine infections are quite common in elderly populations. They tend to affect women more than men; though elderly male patients placed on catheters could also get urine infections frequently. The problem with treating UTI in the elderly is that they are often asymptomatic. As a result, they tend to go unnoticed for a long time leading to various complications. In normally alert and active elderly people, UTIs typically present themselves in the form of sudden and unexplained delirium or confusion. In this guide, we will consider everything there is one needs to know when dealing with UTI in the elderly, particularly complications that may arise with it, as well as methods of treating and preventing them.

UTI in the elderly: Complications and symptoms

Can a UTI affect an older patient’s mental state?

Asymptomatic urine infections in the elderly often do not produce any of the regular symptoms such as burning pain during urinating, fever, abdominal pain etc that are typically seen in younger patients. The main symptoms of urine infection in elderly populations include:

Headaches

Behavior changes, confusion and memory loss that seem to strike suddenly: s/he might not be able to perform daily tasks such as buttoning clothes or feeding oneself etc. Many cannot remember the current year, their maiden name, their address or the year they were born in.

Fatigue and weakness are some other symptoms of UTI in elderly

The person might appear depressed, undernourished and dehydrated.

Foul smelling urine might be produced

When left untreated for long, UTI in elderly could cause sepsis. This is characterized by high fever, rapid and irregular heartbeat and even septic shock where there is dangerous lowering of blood pressure. Thus, to answer the question: whether urine infections in the elderly are fatal, the answer is yes. In patients already having weakened immunity or those with heart valve problems, the sudden lowering of blood pressure caused by sepsis can be life threatening. Other than sepsis, urine infections in the elderly can also lead to Pylonephritis as well as permanent kidney damage. The patient might require dialysis to remove the waste from the blood.

Why does UTI lead to confusion and dementia in the elderly?

Every urine infection is a by-product of dehydration and vice a versa. If a patient is already taking medicines for other conditions, these might be affected by the dehydration. Additionally, UTIs in the elderly lead to brain inflammation and temperature changes which could affect a person’s thinking and cognitive functions.

The reason UTI-induced-delirium in elderly is more dangerous because; in such a state, the person is more susceptible to falls, accidents and irrational behavior.

Causes of UTIs in elderly patients

As stated before, women aged 60 and above are more prone to UTIs than men owing to the proximity of the urethral opening and anus. The germs from the anus easily travel to the urethra and bladder due to back-to-front wiping after bowel movement. Also, uterine prolapse, a condition where the walls and muscles of the uterus become structurally weak causing problems emptying the bladder completely can lead to UTIs in elderly females. Urine incontinent men and women who require diapers are more likely to trap germs in the urethra. Elderly patients (of both sexes) having diseases like cancer, diabetes etc could also suffer frequent bladder infections. Other reasons for UTIs in the older populations include the use of catheters. Indwelling catheters generally trap germs despite precautions.

Treating Urine infections in the elderly

It is important to get a dipstick urine test done for patients suspected of having UTI. If s/he is showing signs of dementia, a loved one or caregiver must assist them for collecting early morning sample of urine. A culture test can help the doctor diagnose if it is a lower UTI or upper UTI. The former are slightly easier to treat and they generally respond well to antibiotics. Upper bladder infections might involve kidneys and ureters apart from the bladder and could end up being fatal. In case of UTI in elderly accompanied by confusion and delirium, apart from antibiotics, short-term treatment with anti-psychotic drugs may be needed.

Preventing UTIs in elderly

Recurrent urine infections in elderly are a common problem. To prevent them, it is vital to get a urine test done every few months. Family members should also watch out for confusion, difference in behavior, unusual sleepiness, hallucinations etc in the patients prone to such infections.

Patients with low mobility should have easy access to water. Color coded glasses/cups can be used for this purpose to assess the water drunk on daily basis. Drinking up to 6-8 glasses of water daily is recommended.

It is important that patients empty their bladder frequently. Bathrooms must be equipped with handrails etc to prevent falls. A night light should be placed in the bathroom as well.

Moderate exercise with good diet having fibrous foods is recommended to prevent constipation.

Some evidence supports that UTIs in elderly can be prevented with regular consumption of cranberry supplements or juices.

In case of urinary catheter being used precautions must be followed as stated by the medical expert.

My name is Fran Smithson, I just had a visit to my Gastrointronologist last week and then today I had the pleasure of reading your article on UTI’S. Today has reassured me 100% that I am not loosing my mind, I felt blessed after reading this article because I know now that pain and burning are not always present in UTI’S especially for women after menapause. I wish I had, had even a little clue that somewhere out there existed supporting facts for this diagnosis and maybe the 4 years of hell, shame, manipulation and slowly going insane would not have had such a major
impact on me and my once loving family.
I have always been prone to have UTI’S
and they started in High School and are continueing through my age of 59. The ones in early adulthood had the normal symptoms burning, pain and frequent urrination. I would go to a Dr and they would give me antibiotics and everything was fine. Now in my late years the UTI’S I have been having can not even be compared to my earlier ones. The symptoms are 100% different. After menapause I started getting sick but no frequent or painful
burning during urination . I always felt very tired, confused and depressed. I went to ER a few times and each time I was seen they started testing all my organs to help the Dr.s find an appropriate answer to my problems. A few times I had a low grade fever so I was giving nasuea meds.and antibiotics. Only one time was the word UTI mentioned and honestly I was the one who mentioned it to the Dr. who then ordered a test and it was positive for a UTI. Now the final time this has happened was about 4 years ago after a major car accident happened to me. I was in and out of surgeries 4 times over the next 3 years
As you would know this started me on a journey through continuous use of antibiotics and pain pills. It was horrible
and I felt so bad everyday. I was loosing my short term memory very fast as well as my emotional and mental health. I was having arguments with my 29 year old son and my 33 year old daughter who happens to be a RN and they both live within 5 to 8 miles from me and my sister and her family live about 20 miles from me. Most Moms would be overjoyed at family so close. Before the wreck ,yes but now today, no, Having all the surgeries was way to much on me mentally and physically, I was majorly depressed, taking antidepressants and on strong pain meds for constant pain. This was more than enough to put anyone over the edge. Then imagine slowly adding the symptoms of a upper UTI
and no Dr knows why you are so sick. Everyone starting accusing me of being hooked on these pills so I would try and stop all by myself, which left the Dr very upset with me and made me so much sicker. I even chose to go to a Rehab for pills only to come home and to be told that in 5 weeks I was having a total right hip replacement. Please give me a break. With all my bizarre behavior being observed, my son and his wife started restricting my time with my grandkids until they just stopped all contact. Adding this just added fuel to the fire and took me to such a low place in my life that I would not even thought a place like this existed. My daughter the nurse knew more than the family so she tried to talk to everyone and explain this in medical terms. This only did damage to their relationship.
I am getting near the end of this story but this is that magical moment or the BIG
AH-HA moment that gives you a totally different perspective that I needed so much.
This UTI started 2 years ago and no one even thought of a UTI as being a diagnosis. I had major confusion, 1 major auditory hallucination,
acting different in front of family, short term memory loss, very accident prone like an unsteady gait, profusely sweating
and no joy in my life. I thought I was really loosing my mind. No exercise and not eating good nutritionly caused major high blood pressure and irregular heartbeat. Many trips to Dr and ER but still no mention of UTI. I had started having major bouts with nasuea all days and nights. Projectile vomiting when walking through a store. I said I needed to be seen by my Gastrointronologist ASAP, so I made appt to discuss having a colonoscopy and endoscopy. It was made for October 6,
2016, yea!!!!! One last trip to ER and the normal procedures had started but I asked him to please do a urine test. I had no fever, pain or burning.
My urine was very dirty and a dark brown
in color, no pain or odor. This Dr asked quite a few question, did a few test and 1 came back positive for UTI. He put me on IV
Antibiotics and nausea meds, said he would call my Dr (Gastrointronologist ) in the next few days with the rest of the test results. Within 24 hours I felt like a new person. Dr. called and said I had a very bad UTI and I needed different meds so I started the meds and in a week I could tell my mental state was improving so
much and my physical state was returning to. Now my Dr (Gastrointronologist ) appt came and I went and was so excited to tell him how much better I was feeling but the first thing he said was let me tell you a story about my dear Mom. His story was so much like my story that it gave me chills. All his Mom’s kids started noticing her behaviors as well as signs that something was not right but they were all containing, memory loss, dimentia, loss of
balance or poor gait, very tired, no energy, loss of pleasure or purpose and
the hallucinations just continued on.
The 5 children whom are all Dr.’s now took their Mom to her Dr.’s appt
so they could all discuss her symptoms
and to explain that in her early years she had problems with UTI’S but your normal symptoms were appearing, now they were not sure of what was happening with her now. The Dr performed a UTI test and it came back POSITIVE and the family was very surprised because there were not any of her normal UTI symptoms to be appearing anywhere.
Her other UTI ‘S had the normal common symptoms but after menapause it all changed. Now her kids say that if Mom starts to act weird or strange she must have a UTI and take her to hospital ASAP.
I just loved this story and now that I know about this, that will be where I go first .
I regret the loss and trust of my family but they were ignorant to anything about outside symptoms just like me. All they knew was something was wrong with me and whatever they saw had made it clear to them they did not want me to keep or to visit my grandkids. This was devastating to me. At the same time I had to respect their decesion because as a parent your #1 job is to protect your kids at any price. I left their father because it was my job to protect them and I wanted to protect them do we had to move. They did not understand and their father or our friends did not understand but I knew without a doubt they needed me to protect them. When I viewed it that way it made it a little less hurtful at times. All they knew and saw was their Mom taking
very strong pain meds and they observed some weird behaviors and actions that followed. I even went through a Pain Management Clinic so I would be accountable for my actions. I guess to them it was the only thing that connected the dots and made sense. Must be drugs. No one ever thought of a UTI and why should they think of that , if I had been on the other side I would probably have thought the exact same thing ,

Education is essential for Dr.’s and their patients. The common theme is
Working Together.

I pray everyday that through prayer and time that the healing will start